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Prediction of patient‐specific risk of early preterm delivery using maternal history and sonographic measurement of cervical length: a population‐based prospective study
Author(s) -
To M. S.,
Skentou C. A.,
Royston P.,
Yu C. K. H.,
Nicolaides K. H.
Publication year - 2006
Publication title -
ultrasound in obstetrics and gynecology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.202
H-Index - 141
eISSN - 1469-0705
pISSN - 0960-7692
DOI - 10.1002/uog.2773
Subject(s) - medicine , preterm delivery , obstetrics , gestation , singleton , prospective cohort study , population , false positive rate , pregnancy , gynecology , pediatrics , surgery , genetics , environmental health , biology , statistics , mathematics
Abstract Objective To develop a model for calculating the patient‐specific risk of spontaneous early preterm delivery by combining maternal factors and the transvaginal sonographic measurement of cervical length at 22 + 0 to 24 + 6 weeks, and to compare the detection rate of this method to that achieved from screening by cervical length or maternal characteristics alone. Methods This was a population‐based prospective multicenter study involving 40 995 unselected women with singleton pregnancies attending for routine hospital antenatal care in London, UK. Complete follow‐up was obtained from 39 284 (95.8%) cases. The main outcomes were detection rate, false‐positive rate and accuracy of predicting spontaneous delivery before 32 weeks' gestation. Results Spontaneous delivery before 32 weeks occurred in 235 (0.6%) cases. The detection rate of screening for early preterm delivery, at a fixed false‐positive rate of 10%, was 38% for maternal factors, 55% for cervical length and 69% for combined testing. There was good agreement between the model estimates and the observed probabilities of preterm delivery. Conclusions This study provides a model that can give an accurate patient‐specific risk of preterm delivery. The detection rate of screening by a combination of maternal factors and the measurement of cervical length was substantially higher than that of screening by each method alone. Copyright © 2006 ISUOG. Published by John Wiley & Sons, Ltd.